Do general practitioners change how they use the computer during consultations with a significant psychological component?

Chan, Wai-Sun; Stevenson, Michael; McGlade, Kieran

doi:10.1016/j.ijmedinf.2007.10.005

Cited by 36 publications

(22 citation statements)

References 11 publications

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“…29,30,50 Eight studies described variation in the amount and manner in which the EMR was used. 15,36,39,41,46,48,51,54 Four studies examined typing behaviors 33,37,42,48 and six reported on screen positioning, with only 8-10 % active screen sharing during the visit. 29,30,33,37,38,52 Interestingly, one study noted patients had a more positive attitude towards the EMR when they were shown the screen.…”

Section: Characterizing Emr Communication Behaviorsmentioning

confidence: 99%

Impact of Electronic Medical Record Use on the Patient–Doctor Relationship and Communication: A Systematic Review

et al. 2016

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BACKGROUND: While Electronic Medical Record (EMR) use has increased dramatically, the EMR's impact on the patient-doctor relationship remains unclear. This systematic literature review sought to understand the impact of EMR use on patient-doctor relationships and communication.METHODS: Parallel searches in Ovid MEDLINE, PubMed, Scopus, PsycINFO, Cochrane Library, reference review of prior systematic reviews, meeting abstract reviews, and expert reviews from August 2013 to March 2015 were conducted. Medical Subject Heading terms related to EMR use were combined with keyword terms identifying face-to-face patient-doctor communication. English language observational or interventional studies were included. Studies examining physician attitudes only were excluded. Structured data extraction compared study population, design, data collection method, and outcomes. RESULTS: Fifty-three of 7445 studies reviewed met inclusion criteria. Included studies used behavioral analysis (28) to objectively measure communication behaviors using video or direct observation and pre-post or crosssectional surveys to examine patient perceptions (25). Objective studies reported EMR communication behaviors that were both potentially negative (i.e., interrupted speech, low rates of screen sharing) and positive (i.e., facilitating questions). Studies examining overall patient perceptions of satisfaction, communication or the patient-doctor relationship (n=22) reported no change with EMR use (16); a positive impact (5) or showed mixed results (1). Study quality was not assessable. Small sample sizes limited generalizability. Publication bias may limit findings. DISCUSSION: Despite objective evidence that EMR use may negatively impact patient-doctor communication, studies examining patient perceptions found no change in patient satisfaction or patient-doctor communication. Therefore, our findings should encourage providers to adopt the EMR as a communication tool. Future research is needed to better understand how to enhance patientdoctor-EMR communication. This research should correlate observed physician behavior to patient satisfaction, focus on physician communication skills training, and explore inpatient experiences.

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Section: Characterizing Emr Communication Behaviorsmentioning

confidence: 99%

Impact of Electronic Medical Record Use on the Patient–Doctor Relationship and Communication: A Systematic Review

et al. 2016

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“…recording data as it emerges naturally during the consultation) 19. By 2008, there was little evidence that clinicians had learnt to multitask, instead developing strategies to ‘insert’ dedicated time for computer use into the consultation 20 – 22. Analysis of speech in 10-min consultations for hypertension revealed an average of 2-min silence when clinicians concentrated on the computer.…”

Section: Introductionmentioning

confidence: 99%

“How long does it take?” A mixed methods evaluation of computer-related work in GP consultations

Hayward

Buckingham

Thomson

et al. 2015

jhi

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Background Systematic reviews have suggested that time spent on computerrelated tasks increases consultation length. However, these reviews pre-date the current ubiquitous use of computers in U.K. general practice. Objective As part of a U.K. national study of the influence of information technology (IT) on the interaction between patients and healthcare professionals during consultations, we explored how IT functions affected time allocation and styles of computer use during general practitioner (GP) consultations. Methods We drew on multichannel video recording of consultations and measured consultation phases and the duration of computer-related tasks. We related measures of actual time to GP's interpretation of computer use elicited in qualitative interviews. Results Our sample included recordings of 112 consultations from 6 GPs in three practices. The computer was used for about one-third of the greater consultation. However, its use was concentrated pre-and post-the patient consultation. The workflow of consultation was exemplified through six computer use cases. Most functionality was accepted and accommodated within the consultation, though

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“…16 However, the design of the study was such that we do not know if those patients with apparently non-psychological problems would have raised additional psychological problems given the opportunity. More research is needed to clarify these issues, but the concern is that the more we use the computer, the less we look at our patients, the less we say to our patients and, in particular, the less we ask about psychosocial aspects of the illness and respond to emotional aspects of their care.…”

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confidence: 99%

Doctors'non-verbal behaviour in consultations: look at the patient before you look at the computer

Silverman

Kinnersley²

2010

Br J Gen Pract

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Do general practitioners change how they use the computer during consultations with a significant psychological component?

Cited by 36 publications

References 11 publications

Impact of Electronic Medical Record Use on the Patient–Doctor Relationship and Communication: A Systematic Review

Impact of Electronic Medical Record Use on the Patient–Doctor Relationship and Communication: A Systematic Review

“How long does it take?” A mixed methods evaluation of computer-related work in GP consultations

Doctors'non-verbal behaviour in consultations: look at the patient before you look at the computer

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